Combined total body X-ray irradiation and total skin electron beam radiotherapy with an improved technique for mycosis fungoides

Journal Article · Tue Aug 01 04:00:00 EDT 1989 · International Journal of Radiation Oncology, Biology and Physics; (USA)

DOI:https://doi.org/10.1016/0360-3016(89)90461-6· OSTI ID:5544140

Halberg, F E; Fu, K K; Weaver, K A; Zackheim, H S; Epstein, Jr, E H; Wintroub, B U

Twelve consecutive patients with advanced stage mycosis fungoides (MF) were treated with combined total body X ray irradiation (TBI) and total skin electron beam radiotherapy (EBRT). Six had generalized plaque disease and dermatopathic nodes, three had tumor stage disease and node biopsy positive for mycosis fungoides, and three had erythroderma/Sezary syndrome. The treatment regimen consisted of split course total body X ray irradiation, given in twice weekly 15 cGy fractions to 75 cGy, then total skin electron beam radiation therapy given in once weekly 400 cGy fractions to a total dose of 2400 cGy. Underdosed areas and areas of greatest initial involvement were boosted 400 cGy twice weekly for an additional 1200 cGy. This was followed by a second course of total body X ray irradiation, to a total dose of 150 cGy. The total skin electron beam radiotherapy technique is a modification of an established six position EBRT technique for mycosis fungoides. Measurements to characterize the beam with and without a lexan scattering plate, demonstrated that the combination of no-plate beams produced better dose uniformity with a much higher dose rate. This improved technique is particularly advantageous for elderly and/or frail patients. Nine (75%) of the 12 patients achieved complete response (CR). The other three had significant improvement with greater than 80% clearing of their disease and resolution of symptoms. All six patients with generalized plaque disease achieved complete response and remained free of disease from 2 to 16 months. Two of three node positive patients also achieved complete response; one, with massive biopsy-documented mycosis fungoides nodal disease and deep open tumors, remained relapse-free over 2 years. Only one of the three patients with erythroderma/Sezary syndrome achieved a complete response, which was short lived.

• OSTI ID: 5544140
• Journal Information: International Journal of Radiation Oncology, Biology and Physics; (USA), Journal Name: International Journal of Radiation Oncology, Biology and Physics; (USA) Vol. 17:2; ISSN IOBPD; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

550603* -- Medicine-- External Radiation in Therapy-- (1980-)
62 RADIOLOGY AND NUCLEAR MEDICINE
BEAMS
BODY
DISEASES
DOSES
ELECTROMAGNETIC RADIATION
ELECTRON BEAMS
EXTERNAL IRRADIATION
FRACTIONATED IRRADIATION
IONIZING RADIATIONS
IRRADIATION
LEPTON BEAMS
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PARTICLE BEAMS
RADIATION DOSES
RADIATIONS
RADIOLOGY
RADIOTHERAPY
SKIN
SKIN DISEASES
THERAPY
WHOLE-BODY IRRADIATION
X RADIATION